Cognitive Behavior Therapy:
Why use it in schools?
Amber Spicer
Techniques of Individual Counseling
CLED 602
Cognitive behavioral therapy(CBT) is an “action-oriented model of therapy that
stresses the role of thinking and belief systems as the root of personal problems (Corey,
2005).” It is an insight-focused therapy that emphasizes recognizing and changing the
negative thoughts and maladaptive beliefs of a client. Assumptions of cognitive
behavioral therapy were initially developed by Albert Ellis in Rational-Emotive Behavior
Therapy(REBT) and, then, later altered by Aaron Beck with Cognitive Therapy(CT) and
Donald Meichenbaum with Cognitive Behavioral Modification.(CBM). Although, rooted
in many of the same assumptions and key concepts, Rational-Emotive Behavior Therapy,
Cognitive Therapy and Cognitive Behavior Modification have specific differences.
REBT is a directive, persuasive, and confrontational form of therapy in which the
therapist fulfills the role of a teacher. REBT claims that clients have negative “irrational”
thoughts when faced with an activating event. If clients confront these thoughts and
change them, then wanted changes in behaviors/reactions will follow.
Beck’s CT recommends that the therapist pose open-ending questions to clients
with the goal of getting clients to reflect on personal issues and arrive at their own
conclusions. Cognitive therapists believe that clients are living by and responding to life
events based on a set of self-developed life “rules” that are too absolute, broad, or
extreme. CT asks clients to gain insight to their “automatic thoughts” and determine if
these thoughts are “cognitive distortions.” If so, clients are to engage in dialogue with
the therapist, carry out homework assignments, gathering and recording data on
assumptions they make, and form alternative interpretations.
Finally, Meichenbaum’s CBM is unique because this theory focuses on changing
the clients’ self-verbalizations. CBM proposes that “behavioral change occurs through a
sequence of mediating processes involving the interaction of inner speech, cognitive
structures and behaviors, and their resultant outcomes (Corey, 2005).” Meichenbaum
helps clients become more aware of their self-verbalizations through the utilization of a
three phase self-instructional training process. First, each client must complete selfobservations of how they think, feel, behave, and impact others. Second, clients start
new internal dialogue. Finally, clients learn and apply new coping skills.
There are many reasons as to why cognitive-behavioral therapy(CBT) could and
should be used for various populations and contexts, especially a school counseling
setting. Although there are many methods or techniques that utilize the beliefs and
assumptions of cognitive-behavioral therapy, altogether CBT is a highly structured,
relatively short-term, focused psychotherapy for a wide range of potential problems.
Also, when considering the time constraints, potential variety of developmental
problems, and amount of depth a school counselor typically reaches in a relationship with
a student, CBT is a realistic approach to use because it is “action-oriented, practical,
rational approach that helps the client gain independence and effectiveness in dealing
with real-life issues (2002).”
To begin, cognitive-behavioral therapy is a counseling approach that lends itself
to a very systematic therapeutic process making it an approach that is applicable to a
population that needs clear, concise, purposeful counseling. Using a step-by-step process
allows clients to set personal goals, see their progress throughout the counseling process,
and, eventually, to independently solve problems they may face in the future. For the
same reasons certain adult clients may prefer this approach, students of any age will also
benefit from the organized format as well.
Students are comfortable with a learning environment in which someone teaches
them skills. Therefore, using CBT in schools, first, allows counselors to play the role of a
counselor, helping students gain insight to their own negative thoughts and draw their
own conclusions on how to change their negative thinking and behaviors. However,
through CBT school counselors also can play a more directive teacher role and “work
collaboratively with the child and his or her parents to specify the problem, and develop
an individualized treatment plan(2002).” As the student works through the structured,
goal directed plan, a child’s self-esteem and competence grows as he/she learns and
practices new skills and problem-solving strategies taught by the counselor(2002).
Secondly, cognitive-behavioral therapy is an approach that is applicable for a
population of clients that do not have a lot of time to spend in counseling. CBT is an
approach to counseling that tries to work efficiently in fourty-five minute sessions or less.
Unlike other un structured forms of therapy, the client and therapist set agendas for
sessions that discuss homework assignments, a review of accomplishments, and one or
two current problems. The goal of each session to focus on the present issues and solve
problems, not just complain about them.
When working as a school counselor, it is obvious that a student population is one
in which most of their time and energy is focused on academics. Thus, a school
counselor needs to use a counseling approach, like CBT, that is efficient and goal
oriented. More specifically, school counselors use CBT because it is a practical approach
that identifies a student’s problem, generates realistic solutions, accommodates
homework, and teaches self-help strategies in a short period of time. All these stages
could even be completed in one session, if necessary.
One example of the implementation of efficient CBT in school counseling is a
program called the Cognitive Behavioral Intervention for Trauma in Schools (CBITS).
CBITS is a “collaborative project with the Los Angeles School District that provides
mental health screening and a standardized brief cognitive behavior therapy treatment in
schools for students who have been exposed to violence (2003).” After administering a
pilot study, CBITS discovered that many more students than expected reported
significant community violence exposure and trauma-related Depression and/or PostTraumatic Stress Disorder. Unfortunately, most, it not all, of these students were not able
to afford any private counseling, therefore the public school setting seemed to be a best
resort to helping these students. In order to reach as many students as possible, CBITS
was developed to reach these students in need mainly because it is a brief approach to
therapy. The program proved to be very successful.
In addition, cognitive-behavioral therapy is an approach that is applicable to any
population that may have a large variety of psychological disorders. Although schools
may differ in socioeconomic status, geographic region, or amount of cultural diversity, all
children suffer from many of the same or related issues, and, thus, schools are an ideal
environment in which to use CBT with students of all developmental stages. Cognitivebehavioral therapy provides comprehensive treatment to many childhood disorders, such
as depression, anxieties and fears, obsessive-compulsive disorders, attention
deficit/hyperactivity disorder, disruptive and noncompliant disorders, social skills
training, and eating disorders. It is certainly beneficial for a school counselor to
understand and to be equipped with an approach like CBT because he/she is then able to
counsel many students with such diverse and extreme problems using just one approach.
Two of many areas of concern for children in schools are depression and
antisocial behaviors. Rienecke and Simons discuss certain circumstances that make
children vulnerable to depression may be puberty, changes in a family and social
network, changes in educational environment, and other stresses and life events, such as
divorce, death, etc. (Reinecke and Simons, 2005) In an attempt to counsel children
experiencing depression, TADS, a counseling program based on a “CBT model has
important practical implications” and has proven to be very successful with most
children.(Reinecke and Simons, 2005)
Cognitive-Behavioral therapy has also proven to be successful in a study of
counseling children who have been referred for antisocial behavior. Children, ages
seven-thirteen, referred to counseling with severe antisocial behavior were assigned to
one of three treatments, one of which being CBT/problem-solving skills training. Those
children that received CBT/problem-solving skills training “showed significantly greater
reductions in antisocial behavior and overall behavior problems, and greater increases in
pro-social behavior(Kazdin, 1989).”
As you can see, cognitive-behavioral therapy is a practical approach to utilize
when counseling a population that requires a structured form of therapy, a brief, efficient
and goal-oriented form of therapy, and a therapy that can be applied to a variety of
psychological problems, specifically depression and antisocial behavior. It is for these
three reasons that CBT is a beneficial approach to practice as a counselor, especially
school counselors that need to provide efficient, quality counseling services to meet the
diverse needs of many different students.
Cognitive-behavioral therapy, like all theories in counseling, has limitations for
multicultural counseling. Due to the fact that CBT requires clients to explore in depth
their core values and beliefs, it is only ethical for the therapist/counselor “to have some
understanding of the cultural background of a client and to be sensitive to their
struggles(Corey, 2005).” Also, diverse cultures may be hesitant or offended to CBT
because it is an approach that asks the client to confront their basic cultural values. One
final potential limitation of CBT is that culturally diverse clients may become dependent
on the counselor to tell them appropriate ways to solve problem and to make decisions
for them.
Reference
Corey, Gerald (2005). Theory and Practice of Counseling and Psychotherapy.
Belmont, CA: Brooks/Cole-Thompson Learning.
Kazdin, A.E., Bass, D., Siegel, T., & Thomas, C. (1989). Cognitive-Behavioral
therapy and relationship therapy in the treatment of children referred for
antisocial behavior. Journal of Consulting Clinical Psychology, 57, 522-35.
Reinecke, AuthorMark A., & Simons, Anne (2005). Vulnerability to depression among
adolescents: Implications for cognitive-behavioral treatment. Cognitive and
Behavioral Practice. 12, 166-176.
(2003). Child and Adolescent Treatment. Retrieved September 23, 2006, from The
American Institute for Cognitive Therapy Web site:
http://www.cognitivetherapynyc.com/
(2002). UCLA Health Services Research Center. Retrieved September 24, 2006, from
Cognitive behavioral intervention for Trauma in Schools Web site:
http://www.hsrcenter.ucla.edu/research/cbits.shtml
Cognitive-Behavioral Therapy Technique
Technique Name: Magic Box Thoughts
Theory on which it is based: Cognitive-Behavioral Therapy Technique
Purpose-Goal and Objectives:
 The student will recognize his/her negative self-talk that is causing current
problems in the classroom.
 The student will generate his/her own positive self-talk to confront his/her
negative thoughts.
 The student will be able to conscientiously think about his/her negative thoughts
and try to transform them into positive thoughts and thus positive behavioral
reactions in the classroom.
Counseling Stage Appropriate: middle/working stage
Age Group: Third/Fourth Graders
Population: depressed students/ students with low self-esteem
Length of time needed: 20-30 minutes
Materials needed: Magic Box thoughts Sheet, notecards, magic box(tape, scissors,
markers), pencil
Steps to doing the technique:
Previous session/homework- Write on notecards negative self-talk that you experience in
school and at home.
Seesion Plans:
1. Share and review completed notecards.
2. Review the theory that we do and feel things simply because we think such
negative thoughts about ourselves. Provide examples.
3. Complete Magic Box worksheet.
4. Write all generated positive self-talk sayings on notecards and place in the
positive side of the Magic Box.
5. Demonstrate Magic Box. Place the negative notecard in one side. Discuss that
the Magic Box transforms the negative thoughts to positive thoughts. Explain
that your brain can do the same thing.
6. Next, explain that when you feel as though you are talking negative talk write it
down on a notecard and place it in the Magic Box. After placing the negative
self-talk in one side, then pick out a positive self-talk notecard from the other side.
7. Explain that you, as a student, can make these transitions to your thoughts just
like the Magic Box. However, whenever you are faced with a negative thought
and you just need some help to get you thinking more positively about yourself
you can put in a negative self-talk card and talk out a positive self-talk card.
8. Make sure the student understands that occasionally you may need to replace the
positive self-talk cards occasionally. However, after awhile you should be more
aware of your self-talk and should have enough practice with positive self-talk
that the Magic Box may not even be necessary anymore.
9. Give the Magic Box full of positive talk cards to the students to take home and
practice for homework.
10. Review next time how it is working.
Name:______________________________ Date:_____________________________
Directions: Fill in three negative self-talk statements that you have experienced in the
past week. After doing so, fill in three positive self-talk statements for each negative
self-talk statement. Then copy all your positive self-talk onto notecards and place the
notecards in the positive side of the Magic Box.
Negative Self-Talk
1.
Positive Self-Talk
a)
b)
c)
2.
a)
b)
c)
3.
a)
b)
c)
4.
a)
b)
c)